TrinityYouth Registration TrinityYouth Registration Information Step 1 of 3 33% Student InformationStudent Name* First Last Birthdate* MM slash DD slash YYYY School*Grade in School* 6th 7th 8th 9th 10th 11th 12th Student Email (if applicable) Please list any allergies: Parent InformationFather's Name* First Last Phone*Email* Mother's Name* First Last Phone*Email* Address* Street Address City State / Province / Region ZIP / Postal Code Preferred Method of Contact* Text Email Emergency Contact*Who do we call in the event we cannot get ahold of either parent?Emergency Contact Phone* Blanket Permission:* I agree.I hereby grant permission for my child named above to participate fully in any or all of the activities/programs that are held on or off-site with the student ministries of Trinity Community Church, Roslyn, PA.Release of Liability:* I agree.I understand that the Staff and volunteers of Trinity Community Church will endeavor to provide individual care and safety for each participant in each activity/program. I am aware that neither the Church nor any staff or volunteer supervisor can assume responsibility for any injury or damage, which may occur in connection with such program/activity. Therefore, by indicating above, I am releasing and/or holding harmless the Church, staff, and volunteers from any liability incurred arising out of any church-sponsord activity in which my child participates.Medical Authorization* I agree.I give my consent, approval and authorization for Church staff or other adult supervisors to authorize emergency medical treatment for my child if reasonably deemed necessary by them.PhoneThis field is for validation purposes and should be left unchanged.
